Pre-existing Small Vessel Disease in Patients with Acute Stroke from the Middle East, Southeast Asia, and Philippines

Pre-existing Small Vessel Disease in Patients with Acute Stroke from the Middle East, Southeast... Asymptomatic small vessel disease (SVD), including white matter hyperintensities (WMHIs), periventricular hyperintensities (PVHIs), silent stroke (SS), and cerebral microbleeds (CMBs), increases the risk of stroke. There are limited studies of SVD in subjects from the Middle East and Southeast Asia (SA). All patients admitted to stroke service between 2014 and 2015 were reviewed for presence of “pre-existing” SVD. Stroke mimics with no previous history of stroke were used as controls. There were 1727 patients admitted with stroke. Analysis was done on 988 subjects (914 strokes and 74 controls) who had MRI scan done. Pre-existing SVD was seen in 642 (64.9%) patients (WMHIs 19.6%, PVHIs 33.2%, SS 51.4%, and CMBs 22%). Silent strokes were significantly more common with ischemic stroke (IS) compared to intracranial hemorrhage (ICH) (62.0 vs 34.3%, p < 0.001). CMBs were more in ICH compared to IS (42.9 vs 23.1%, p < 0.001). The risk of developing CMBs among Far Eastern (FE) patients was 1.58 times more (p = 0.07), while 1.48 times more in Arabs (AR) (p = 0.026) compared to SA after adjusting for age. The risk of developing PVHIs was significantly higher in Arab compared to SA (odds ratio (OR) 1.43; p value = 0.021). Similarly, the risk of developing WMHIs was also significantly higher in AR patients (OR 1.6; p value = 0.009) compared to SA. The majority of ethnic AR, SA, and FE populations show pre-existing SVD on MRI. The advanced changes at a young age may be related to high prevalence of untreated risk factors and possibly as yet defined genetic and environmental factors. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Translational Stroke Research Springer Journals

Pre-existing Small Vessel Disease in Patients with Acute Stroke from the Middle East, Southeast Asia, and Philippines

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Publisher
Springer Journals
Copyright
Copyright © 2017 by Springer Science+Business Media, LLC
Subject
Biomedicine; Neurosciences; Neurology; Cardiology; Neurosurgery; Vascular Surgery
ISSN
1868-4483
eISSN
1868-601X
DOI
10.1007/s12975-017-0578-7
pmid
29101611
Publisher site
See Article on Publisher Site

Abstract

Asymptomatic small vessel disease (SVD), including white matter hyperintensities (WMHIs), periventricular hyperintensities (PVHIs), silent stroke (SS), and cerebral microbleeds (CMBs), increases the risk of stroke. There are limited studies of SVD in subjects from the Middle East and Southeast Asia (SA). All patients admitted to stroke service between 2014 and 2015 were reviewed for presence of “pre-existing” SVD. Stroke mimics with no previous history of stroke were used as controls. There were 1727 patients admitted with stroke. Analysis was done on 988 subjects (914 strokes and 74 controls) who had MRI scan done. Pre-existing SVD was seen in 642 (64.9%) patients (WMHIs 19.6%, PVHIs 33.2%, SS 51.4%, and CMBs 22%). Silent strokes were significantly more common with ischemic stroke (IS) compared to intracranial hemorrhage (ICH) (62.0 vs 34.3%, p < 0.001). CMBs were more in ICH compared to IS (42.9 vs 23.1%, p < 0.001). The risk of developing CMBs among Far Eastern (FE) patients was 1.58 times more (p = 0.07), while 1.48 times more in Arabs (AR) (p = 0.026) compared to SA after adjusting for age. The risk of developing PVHIs was significantly higher in Arab compared to SA (odds ratio (OR) 1.43; p value = 0.021). Similarly, the risk of developing WMHIs was also significantly higher in AR patients (OR 1.6; p value = 0.009) compared to SA. The majority of ethnic AR, SA, and FE populations show pre-existing SVD on MRI. The advanced changes at a young age may be related to high prevalence of untreated risk factors and possibly as yet defined genetic and environmental factors.

Journal

Translational Stroke Research – Springer Journals

Published: Nov 3, 2017

References

  • Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges
    Pantoni, L
  • Total small vessel disease score and the risk of recurrent stroke
    Lan, KK; Li, L; Schulz, U; Simoni, M; Chan, KH; Ho, SL
  • Risk factors, stroke prevention treatments, and prevalence of cerebral microbleeds in the Framingham Heart Study
    Romero, JR; Preis, SR; Beiser, A; DeCarli, C; Viswanathan, A; Martinez-Ramirez, S
  • Prestroke vascular pathology and the risk of recurrent stroke and poststroke dementia
    Portegies, MLP; Wolters, FJ; Hofman, A; Ikram, MK; Koudstaal, PJ; Ikram, MA
  • White matter hyperintensity on cranial magnetic resonance imaging: a predictor of stroke
    Kuller, LH; Longstreth, WT; Arnold, AM; Bernick, C; Bryan, RN; Beauchamp, NJ
  • Cerebral microbleeds: a guide to detection and interpretation
    Greenberg, SM; Vernooij, MW; Cordonnier, C; Viswanathan, A; Salman, RA; Warach, S
  • Silent brain infarction and the risk of future stroke. A systemic meta-analysis
    Gupta, A; Giambrone, AE; Gialdini, G; Finn, C; Delgado, D; Gutierrez, J
  • Stroke in developing countries: can the epidemic be stopped and outcomes improved
    Feigin, VL
  • Tracking the global burden of stroke: the need for large scale international studies
    O’Donnell, M; Yousef, S
  • Stroke in South Asian countries
    Wasay, M; Khatri, IA; Kaul, S
  • Global variations in stroke burden and mortality: estimates from monitoring, surveillance and modelling
    Johnson, SC; Mendis, S; Mathers, CD
  • Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study
    O’Donnell, MJ; Xavier, D; Liu, L; Zhang, H; Chin, SL; A-Melacini, P
  • Stroke in Asia: geographical variations and temporal trends
    Mehndiratta, MM; Khan, M; Mehndiratta, P; Wasay, M
  • Global burden of stroke and risk factors in 188 countries during 1988-2013
    Feigin, VL; Roth, GA; Naghavi, M; Parmar, P; Krishnamurthi, R; Chugh, S
  • Ethnic variation in acute cerebrovascular disease: analysis from the Qatar stroke registry
    Akhtar, N; Salam, A; Kamran, S; Bourke, P; Joseph, S; Santos, M
  • Beneficial effects of implementing stroke protocols require establishment of a geographically distinct unit
    Akhtar, N; Kamran, S; Singh, R; Cameron, P; D’Souza, A; Imam, Y
  • Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in acute stroke treatment
    Adam, HP; Bendixen, BH; Kappelle, LJ; Biller, J; Love, BB; Gordon, DL
  • MR imaging of the aging brain: patchy white-matter lesions and dementia
    Brant-Zawadzki, M; Fein, G; Dyke, C; Kiernan, R; Davenport, L; Groot, J
  • Peri ventricular hyperintensity as seen by magnetic resonance: prevalence and significance
    Zimmerman, RD; Fleming, CA; Lee, BCP; Saint-Louis, LA; Deck, MD
  • MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging
    Fazekas, F; Chawlak, JB; Alavi, A; Hurtig, HI; Zimmerman, RA
  • Cerebral microbleeds: new dilemma in stroke medicine
    Kakar, P; Charidimou, A; Werring, DJ
  • Cerebral microbleed detection and mapping: principles, methodological aspects and rationale in vascular dementia
    Charidimou, A; Jäger, HR; Werring, DJ
  • Incident cerebral microbleeds in a cohort of intracerebral hemorrhage
    Pasquini, M; Bebedictus, MR; Boulouis, G; Rossi, C; Dequatre-Ponchelle, N; Cordonnier, C
  • White matter injury and ischemic stroke
    Wang, Y; Liu, G; Hong, D; Chen, F; Ji, X; Cao, G
  • Associations and implications of cerebral microbleeds
    Kleining, TJ
  • Cerebral white matter lesions, retinopathy and incident clinical stroke
    Wong, T; Klein, R; Sharrett, AR; Couper, DJ; Klein, BE; Liao, DP
  • Prevention of stroke in patients with silent cerebrovascular disease
    Smith, EE; Saposnik, G; Biessels, GJ; Doubal, FN; Fornage, M; Gorelick, PB

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